Hospital length of stay following hematopoetic stem cell transplant (HSCT) has been reduced from months to days. Family caregivers (FCGs) must manage several different disruptive symptoms, detect and respond to a range of life threatening complications, communicate with health care professionals about changes in recipients' condition, and implement a complex and constantly changing medication regimen. Prior work demonstrates that FCGs feel unprepared to assume these responsibilities, especially managing physical and emotional symptoms. Despite the obvious impact of FCGs on morbidity and the dire nature of this acute caregiving situation, research in this population tends to describe symptoms or caregiving rather than focusing on the link between caregiving and recipients' outcomes. The purpose of this project is to develop, feasibility test, and pilot test a new intervention designed to prepare FCGs with skills for assuming post transplant care of the HSCT recipient. The Symptom Assessment & Management Skill-building intervention (SAM-Skill) is based on descriptive and correlational studies of FCG care of HSCT recipients, address the concerns and priorities for family caregiving articulated by HSCT health care professionals, and is designed to address a specific set of barriers to symptom management and safety concerns identified in our preliminary work. The specific aims of the project are to: 1) Develop the SAM-Skill intervention; 2) Conduct a feasibility test with FCGs of HSCT recipients; 3) Obtain preliminary evidence of the efficacy of SAM-Skill in improving HSCT recipients' symptom intensity, disruption in function, medication adherence, contact with health care providers and FCGs1 caregiving role strain. The SAM-Skill intervention and control interventions will be developed using focus groups and a consensus meeting with a panel composed of HSCT health care professionals and experienced FCGs; content analytic techniques will be used to develop the intervention. The feasibility test will be evaluated with FCGs' reports about relevance of the intervention; content analytic techniques will be used to refine SAM-Skill. The effect size for the efficacy of SAM-Skill will be computed for each outcome variable. [unreadable] [unreadable]